KK Women's and Children's Hospital (KKH) Department of Gynaecological Oncology shares the treatment strategy to improve survival for ovarian cancer patients.
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Ovarian cancer cases in Singapore are on the rise as women live longer and have children at a later age. Coupled with modern lifestyle factors, women are more prone to developing ovarian cancer. Currently, there are no effective screening methods, making it difficult to catch the disease at its early stage.
Symptoms are not very specific and the cancer is often found when it is in the advanced stage, thereby limiting the treatment options.
Treatment for ovarian cancer
The first step of treatment for ovarian cancer is surgery to remove the ovaries, womb and cervix as well as the lymph nodes. If the patient is young and at an early stage of the disease, the womb may be saved for future childbearing.
The second step of treatment is chemotherapy for patients who are at an advanced stage of the cancer to reduce the risk of relapse. The current international standard for chemotherapy is a combination of a platinum containing chemotherapy agent as well as paclitaxel (a compound derived from the Pacific Yew tree). A new treatment method called targeted therapy is used to inhibit a protein that stimulates new blood vessel formation. This method is usually used in combination with conventional chemotherapy.
“Targeted therapy is a type of medication that blocks the growth of cancer cells rather than simply interfering with rapidly dividing cells,” says Dr Lim. Treatment to shrink a tumour before surgery (neoadjuvant chemotherapy), is also an option in patients who are not surgically fit at the time of diagnosis, he adds.
Surviving Ovarian Cancer
Ovarian cancer can be cured if it is diagnosed at an early stage, with the five-year survival at stage 1 being 76 to 93 per cent. If the cancer is diagnosed at stage 3 or 4, the five-year survival rate drops to less than 30 per cent. About 40 per cent of women are diagnosed at stage 1 or 2 in Singapore.
While the prevention of ovarian cancer is difficult, Dr Lim says, research has shown that women who have been taking contraceptive pills for five years or more, have a 50 per cent lower risk of getting the disease. Other factors associated with a reduced risk of this cancer include pregnancy (the earlier the better), breastfeeding, hysterectomy and tubal ligation in which the fallopian tubes are blocked to prevent pregnancy.